Listing_of_Employees___Subcontractors_Standard_5.30.23.docx

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Attached to
Master Agreement AZ|CTR070503
Contract number
CTR070503
Issued by
Arizona

About this file

This document is a Listing of Contractor Employees and Subcontractors form from the State of Arizona Department of Child Safety's Office of Procurement, specifically for Arizona Cooperative Therapies under contract numbers CTR055534_Rural and CTR055534_Urban. The document provides a detailed roster of 14 employees and subcontractors who will be engaged in direct client services, including their personal identifiers such as date of birth, date of hire, and fingerprinting clearance card numbers.

The document appears to be related to a contract for providing therapeutic services, with employees hired between 2021 and 2023. The listing includes critical compliance information required for personnel working directly with clients, specifically tracking individual employee credentials and clearance status. While specific contract details are not fully disclosed, the document suggests a focus on child-related services with stringent background check and personnel tracking requirements, typical of contracts involving vulnerable populations.

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LISTING OF CONTRACTOR EMPLOYEES

AND SUBCONTRACTORS

State of Arizona Department of Child Safety Office of Procurement 3003 N. Central Ave Phoenix, AZ 85012

Contractor Name: Arizona Cooperative Therapies

Contract / Solicitation Number: CTR055534_Rural and CTR055534_Urban

Please provide information in the table below for all employees and subcontractors who will be engaged in direct client services under this contract. List the names, date of birth, date of hire, and fingerprinting clearance card number (put pending if card not obtained yet).

Employee/Subcontractor Name
Date of Birth
Date of Hire
Fingerprinting Clearance Card No.
Heather Brown
5/10/1976
6/18/2021
2A01632467
Mandy CasConi
12/29/1983
6/9/2021
2023R13187
Silvia Teng
3/29/1968
5/22/2023
2A50502684
Gloria Castillo
10/18/1946
7/28/2021
2A01793360
Wilo Hassan
6/2/1980
8/17/2021
2021H02893
Wendell Hairston
6/25/1983
10/12/2021
2021F01303
Timmisha Jackson
1/25/1989
11/15/2021
2018E04686
Tory Hunter
10/25/1996
11/26/2021
2020H08313
Terri Grayson
3/23/1985
4/7/2023
2A01498618
Tabitha Roque
12/8/1979
4/7/2023
2023R06200
Patricia Baglione
11/24/1968
4/18/2023
2020R10266
Arlene Gil
8/25/1972
7/20/2021
2A50428399
Ida Vigil
1/8/1946
7/20/2021
2A01061484
Shirlene Bradford
3/12/1948
1/14/2022
2021G05625
Chloe’ Aflague
8/18/1990
8/26/2022
2022E12702

Updated Date ___5/30/2023___________ image1.jpg

File details come from the government source that posted it. Updated .